| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | BLUE CROSS OF CALIFORNIA | $212K | $5K | $217K | 5.54% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN, INC. | $57K | $0 | $57K | 5.16% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | STANDARD INSURANCE COMPANY | $18K | $2K | $19K | 12.04% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | — | $2K | 5.02% |
| SARAH COURTNEY KNAPP3 | 61 SKLAR STREET LADERA RANCH, CA 92694 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $9 | $24 | 4.01% |
| JOHN D EVANGELISTA3 Filed as: JOHN D. EVANGELISTA | 186 LAS FLORES ALISO VIEJO, CA 92656 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $1 | $20 | 3.34% |
| LIBERTY COMPANY INSURANCE BROKERS3 | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 1.67% |
| DANA MARIE MOWATT3 | 23701 SOUTH WESTERN AVENUE SPACE 112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.50% |
| ANDREA MARIE TIERCE | 1199 MADRONE LANE PLACERVILLE, CA 95667 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.33% |
| TECH COORDINATOR CYBER INSURANCE SO | 10741 LA JARA STREET CERRITOS, CA 90703 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.33% |
No Schedule C service providers reported on this filing.
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 461 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 462 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 486 | $5.0M |
| Dental | BLUE CROSS OF CALIFORNIA | 486 | $3.9M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 557 | $44K |
| Life insurance(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 486 | $4.1M |
| Short-term disability(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 486 | $4.1M |
| Long-term disability(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 486 | $4.1M |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 486 | $5.0M |
| Other(4 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 486 | $5.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 557 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.